Hip Flexor or Not?

Is that anterior hip pain a hip flexor strain or something else?

Ah, the good old hip flexors. This isn’t the first time I’ve talked about them and it certainly will not be the last. If you have anterior hip pain that you think stems from your hip flexors, and you simply can’t get rid of it, then keep on reading.

Although it is a common misconception that anterior hip pain results from your hip flexors, this is not always true! Yes, these muscles sit right in the front of your hip and thigh; however, the hip is more than just it’s musculature. There are numerous structures that can contribute to pain.

So, what else is there in the front of the hip that can contribute to pain? 

Many things!

The hip is a ball and socket joint that has multiple degrees of freedom (planes of movement). Aside from the bones, a multitude of supporting muscles, tendons, and ligaments, the hip has cartilaginous structures (articular cartilage and the hip labrum) that also aid in stabilization, shock absorption, and pressure distribution. 

With that little tidbit of information, you can now understand that there are multiple areas where pain can come from. It could be bone, cartilage, muscle, nerve… you name it, it’s near or in your hip joint!

So, how can you tell the difference between a hip flexor strain and something else? Well, first off, a hip flexor strain is normally an overuse injury. Were you running uphill more often, sprinting, kicking, or performing repetitive box jumps? Did you ramp up your activity quickly? One thing to note with a hip flexor injury, the muscle under question will hurt with, 1. activation of the muscle and 2. stretching of the muscle. Pain is not usually felt at rest.  It will also subside fairly quickly with activity modification and gradual return to activity.

Now, if you’ve experienced what you think is a hip flexor muscle strain but it’s not going away, it may be time to explore other options. There are multiple conditions that can cause discomfort in the anterior hip including: 

• Hip osteoarthritis (seen in older adults)
• FAI (femoroacetabular impingement)
• Hip Dysplasia
• Acetabular Labral Tear
• Hip Cartilage Defects
• Stress Fractures of the Hip
• And more….

(Now, if your pain is relentless, waking you up at night, and causes you to limp or not want to bear weight, we do recommend visiting your local healthcare provider for further evaluation.)

Most often, individuals walk into our clinics complaining of hip flexor pain and symptomology tells us otherwise. Have you experienced: 

•       Hip or groin stiffness
•       Deep ache in groin/buttock
•       Sharp pain in groin/buttock with hip flexion > 90 degrees (squatting, high knees, etc.)
•       Pain with leg crossing in sitting or standing.
•       Pain with prolonged sitting
•       Hip pain at rest and/or with activity
•       Low Back Pain
•       Knee Pain

Well, if this sounds like you, it’s time to explore other options. See your local physical therapist or sports medicine physician to have them help you get to the bottom of your discomfort. Oh, and make sure you check out the video below to learn more about hip flexors versus FAI!